The Distance Learning Partnership - ICB registration form
Title
Mr
Mrs
Miss
Ms
Other
Full Name
E-mail Address:
*
Full Postal Address (inc postcode)
*
Daytime Telephone Number
*
Date of Birth
Are you?
Employed Full Time
Employed Part Time
Self Employed
Unemployed
Retired
Student Full Time
Student Part Time
Please answer yes or no to the following questions. If your answer is yes to any of the questions please supply details in confidence by post.
Have you ever been bankrupt?
YES
NO
Do you have any criminal convictions that are not spent under the Rehabilitation of Offenders Act?
YES
NO
Have you ever been found guilty of a civil offence?
YES
NO
Note that only one registration fee is payable. Student registration £45 per annum. Change of details: £25.
Please Tick all Qualifications you are intending to take:
Certificate in Basic Bookkeeping
Certificate in Manual Bookkeeping
Certificate in Computerised Bookkeeping
Certificate in Small Business Financial Control
Diploma in Manual Bookkeeping
Diploma in Computerised Bookkeeping
Diploma in Payroll Mangement
Name
Date
*
Required
